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Determinants of hea...
Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa
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Rautenberg, Tamlyn A. (author)
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Ng, Shu Kay (author)
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- George, Gavin (author)
- Lund University,Lunds universitet,Socialmedicin och global hälsa,Forskargrupper vid Lunds universitet,Social Medicine and Global Health,Lund University Research Groups,University of KwaZulu-Natal
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Moosa, Mahomed Yunus S. (author)
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- McCluskey, Suzanne M. (author)
- Harvard Medical School,Massachusetts General Hospital
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- Gilbert, Rebecca F. (author)
- Massachusetts General Hospital
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Pillay, Selvan (author)
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- Aturinda, Isaac (author)
- Mbarara University of Science and Technology
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- Ard, Kevin L. (author)
- Massachusetts General Hospital,Harvard Medical School
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- Muyindike, Winnie R. (author)
- Mbarara University of Science and Technology
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- Musinguzi, Nicholas (author)
- Mbarara University of Science and Technology
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- Masette, Godfrey (author)
- Mbarara University of Science and Technology
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Pillay, Melendhran (author)
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- Moodley, Pravi (author)
- Massachusetts General Hospital
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Brijkumar, Jaysingh (author)
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- Gandhi, Rajesh T. (author)
- Harvard Medical School,Massachusetts General Hospital
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- Johnson, Brent (author)
- University of Rochester
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Sunpath, Henry (author)
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- Bwana, Mwebesa B. (author)
- Mbarara University of Science and Technology
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- Marconi, Vincent C. (author)
- Emory University,Emory University Rollins School of Public Health
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- Siedner, Mark J. (author)
- Harvard Medical School,Massachusetts General Hospital,Africa Health Research Institute,Mbarara University of Science and Technology
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(creator_code:org_t)
- 2023
- 2023
- English.
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In: Health and Quality of Life Outcomes. - 1477-7525. ; 21:1
- Related links:
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http://dx.doi.org/10... (free)
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Abstract
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- Background: Antiretroviral treatment improves health related quality of life (HRQoL) of people with human immunodeficiency virus (PWH). However, one third initiating first-line treatment experience virological failure and the determinants of HRQoL in this key population are unknown. Our study aims to identify determinants of among PWH failing antiretroviral treatment in sub-Saharan Africa. Methods: We analysed data from a cohort of PWH having virological failure (> 1,000 copies/mL) on first-line ART in South Africa and Uganda. We measured HRQoL using the EuroQOL EQ-5D-3L and used a two-part regression model to obtain by-country analyses for South Africa and Uganda. The first part identifies risk factors that were associated with the likelihood of participants reporting perfect health (utility = 1) versus non-perfect health (utility < 1). The second part identifies risk factors that were associated with the EQ-5 L-3L utility scores for participants reporting non-perfect health. We performed sensitivity analyses to compare the results between the two-part model using tobit models and ordinary least squares regression. Results: In both countries, males were more likely to report perfect health and participants with at least one comorbidity were less likely to report perfect health. In South Africa, participants with side effects and in Uganda those with opportunistic infections were also less likely to report perfect health. In Uganda, participants with 100% ART adherence were more likely to report perfect health. In South Africa, high HIV viral load, experiencing ART side effects, and the presence of opportunistic infections were each associated with lower HRQoL, whereas participants with 100% ART adherence reported higher HRQoL. In Uganda participants with lower CD4 count had lower HRQoL. Conclusion: Markers of advanced disease (opportunistic infection, high viral load, low CD4), side effects, comorbidities and lack of ART adherence negatively impacted HRQoL for PWH experiencing virological failure. Trial registration: ClinicalTrials.gov: NCT02787499.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Keyword
- EQ-5D
- Health related quality-of-life
- Health state utility values
- HIV
- Two part regression
- Virological failure
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Rautenberg, Taml ...
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Ng, Shu Kay
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George, Gavin
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Moosa, Mahomed Y ...
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McCluskey, Suzan ...
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Gilbert, Rebecca ...
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show more...
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Pillay, Selvan
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Aturinda, Isaac
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Ard, Kevin L.
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Muyindike, Winni ...
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Musinguzi, Nicho ...
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Masette, Godfrey
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Pillay, Melendhr ...
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Moodley, Pravi
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Brijkumar, Jaysi ...
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Gandhi, Rajesh T ...
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Johnson, Brent
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Sunpath, Henry
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Bwana, Mwebesa B ...
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Marconi, Vincent ...
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Siedner, Mark J.
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show less...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Public Health Gl ...
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Health and Quali ...
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Lund University